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1EBRA&KA, <br />ROI 1.1.4 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2005000887-0 Pages: <br />Debtor Name: ASIEL NOGUEIRA FUXA <br />Filing Date and Time: 05/27/2020 09:51 AM <br />Notice of State Tax Lien <br />,:.620o3413 <br />This Notice of State Tax Lien is issued by the Nebraska <br />Department of Revenue for unpaid taxes administered by the Tax <br />Commissioner. Taxes, including penalties, interest, and costs, <br />which are shown below, are due from the taxpayer and remain <br />unpaid after demand.These taxes are a lien for all property located <br />in the county and rights to property owned by the taxpayer or <br />acquired before the expiration of this lien.This lien will expire and <br />become unenforceable 10 years after the date of recording if no <br />continuation statement is recorded on or prior to the expiration of <br />the previous lien or continuation statement. <br />PLEASE DO NOT WRITE IN THIS SPACE <br />PLEASE RETURN TO: <br />NEBRASKA DEPT OF REVENUE <br />PO BOX 94609 <br />LINCOLN NE 68509-4609 <br />Nebraska ID Nambee <br />92521991 <br />Lien Servat Number <br />12054911 <br />pato of <br />May 19, 2020 <br />Lien F$e0 With. <br />® Seyismr at Deeds <br />Lao Type: <br />IX) Original <br />Federal ID Number <br />t <br />i Social Security Number <br />Courto'te* I XXX -XX -8078 <br />Li Continuation <br />jj' Corrected <br />acidity Number <br />Coonfy <br />HALL <br />Business Name and Location Address <br />Taxpayer Name and Mailing Address <br />ASIEL NOGUEIRA FUXA <br />2575 N 31ST ST APT 139 <br />NEDERLAND TX 77627 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty I <br />Interest <br />Costs j Total Due <br />Individual <br />2016 <br />05/26/2017 <br />1 <br />$852.00 <br />$42.60 <br />$102.71 <br />997 31 <br />Individual <br />2018 <br />07/02/2019 <br />$1,546 00 <br />$86.30 <br />$84.61 <br />1,716.91 <br />Total <br />$2,714 22 <br />I certify that the Nebraska Department of /reverie has tee:eed wen the laws of the Stale at Nebraska in determining the amount srxrwn to be die, <br />and that the taxpayer has railed to the amount due alter demand. This Notice el Stare Tax Lien is an effective ken and serves to cunt ,tse the priority of <br />the Slate's interest in tftected p rty el ll taxpayer_ <br />sign <br />here 1 Praparerc Surat <br />Auvrunized Signatcre <br />Revenue5(fry <br />Title <br />Revenue Supervisor <br />Tele <br />05/19/2020 <br />Date <br />crex.:9>n Pev, 8.2070 <br />0031632-1203 <br />Picone Number <br />05/19/2020 <br />Data <br />a flew. .0.20:3 <br />